Inpatient Case Management Authorization Technician

Sentara
United States, Virginia, Norfolk
6015 Poplar Hall Drive (Show on map)
Jan 18, 2025
City/State Norfolk, VA Overview Work Shift First (Days) (United States of America) Sentara Health Corporate Office is hiring an Inpatient Case Management Authorization Technician to work full-time/day shift. The Inpatient Case Management Authorization Technician provides assistance to the Inpatient Case Management team under the direction of the ICM RN/MSW, or other team member to coordinate referrals for the purpose of expediting care. Delivers compliance documents or other patient documents Acts as an extension of the ICM RN/MSW, or AA to facilitate referrals, calls for the purpose of expediting patient care to include pre-authorizations when appropriate. Delivers Durable Medical Equipment to the patient or caregiver under the direction of the ICM RN/MSW, or AA Facilitates data entry, patient signature, and processing of LTSS screenings Contacts insurance companies to identify in-network agencies to support patient post-acute needs Gathers, takes action on, and maintains Case Management documentation such as referrals, admissions, orders, and schedules. Participate Gathers Quality Improvement (QI) and department Performance Improvement (PI) data. Provides administrative back-up and main office support as requested Requirements: Medical terminology knowledge and insurance/payor experience preferred. Strong written and verbal communication skills required. keywords: case management technician, Monster, Medical Terminology, Denial Letters, Authorizations Job Summary The Inpatient Case Management Technician is responsible for assisting the Inpatient Case Manager RN/MSW with required tasks for discharge plan facilitation. The ICM Authorization Technician will prepare documents, personal health records, and referral packets for submission to post-acute facilities and agencies. Submits personal health information electronically using approved software or faxes as necessary for post-acute consideration. Competencies/Job Duties: Provides assistance to the Inpatient Case Management team under the direction of the ICM RN/MSW, or other team member to coordinate referrals and recommendations for post-acute level of care to expedite care. Acts as an extension of the ICM RN/MSW, or AA to facilitate referrals for the purpose of expediting patient care to include authorizations. Facilitates data entry, patient signature and processing for post-acute transitions. When required for post-acute transitions, validates that LTSS screenings are documented in the medical record. Contacts insurance companies to identify in-network agencies to support patient post-acute needs. Gathers, takes action on, and maintains Case Management documentation such as referrals, authorizations, Epic lists, etc. Participate/gathers Quality Improvement (QI) and department Performance Improvement (PI) data. Provides administrative back-up and main office support as requested. Provides appropriate communication and ensures all pertinent information is documented in accordance with departmental and regulatory requirements. Posting Process and Review: Reviews and completes personal health record requests and updates as required for post-acute authorizations. Demonstrates knowledge of required health information necessary for post-acute consideration. Demonstrates knowledge of regulatory considerations related to post-acute placement. Demonstrates knowledge of regulatory considerations related to post-acute placement and required delivery timeframes. Medical terminology knowledge and insurance/payor experience preferred. Strong written and verbal communication skills required. Excel and work proficiency preferred. Cross-collaboration with interdisciplinary teams at the division level to obtain timely clinical information required for authorization submission. Qualifications: HS - High School Grad or Equivalent (Required) Customer Service Skills Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application. In support of our mission "to improve health every day," this is a tobacco-free environment.